Quintanas Fairview Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH00001141 Issued in NM

Legal business name

QUINTANAS FAIRVIEW PHARMACY INC

Doing business as

Fairview Pharmacy

Practice address

734 N Riverside Dr
Ste a
Espanola, NM 87532-2957

Phone

(505) 753-2209

Fax

(505) 753-8408

NPI assigned

Jan 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry Quintana, RPH

Title

President

Phone

(505) 753-2209

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• FAIRVIEW PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1407907496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N RIVERSIDE DR",
            "address_2": "STE A",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322957",
            "telephone_number": "505-753-2209",
            "fax_number": "505-753-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 N RIVERSIDE DR",
            "address_2": "STE A",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322957",
            "telephone_number": "505-753-2209",
            "fax_number": "505-753-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINTANAS FAIRVIEW PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "QUINTANA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-753-2209",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00001141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2057691",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55731",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Presbyterian Healthcare Services (Espanola Hospital Home Healthcare)
• Presbyterian Medical Services
• Presbyterian Medical Services (Espanola Family Wellness Center)
• Brandon Allen Quinn, MD, MPH
• Esperanza Quintana
• R-Way LLC
• Herbert V Rachelson, MD
• Sheri Anne Raphaelson, L.M.
• Jennifer Redd, MD
• Michael S Redman, D.M.D.

• Community/Retail Pharmacy in Espanola, NM
• Providers in Espanola, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.